From the Research
The treatment for pneumomediastinum primarily involves supportive care and addressing the underlying cause, with most cases resolving spontaneously within 7-10 days with conservative management.
Key Considerations
- Patients should rest, receive supplemental oxygen if needed to maintain normal oxygen saturation levels, and take analgesics such as acetaminophen or NSAIDs for pain relief 1.
- Bed rest is recommended initially, with gradual return to normal activities as symptoms improve.
- Avoiding activities that increase intrathoracic pressure, such as straining, coughing, or vomiting, is important to prevent worsening of the condition.
Hospitalization and Antibiotics
- In rare cases where pneumomediastinum is severe or causes respiratory compromise, hospital admission for close monitoring may be necessary 2.
- Antibiotics are not routinely needed unless there is evidence of infection.
Underlying Mechanism and Surgical Intervention
- The underlying mechanism of pneumomediastinum involves air leaking from ruptured alveoli into the mediastinum, which typically heals on its own as the body reabsorbs the air.
- Surgical intervention is rarely required except in cases of esophageal perforation or other specific complications that may accompany pneumomediastinum 3.
Recent Guidelines and Recommendations
- A recent comprehensive review of diagnosis and management of spontaneous pneumomediastinum highlights the importance of conservative management and selective use of hospitalization and antibiotics 1.